Background: Identifying ablation targets for persAF is still challenging. Targeting high frequency during AF has been previously proposed as a treatment strategy. Over the last decades, attention has been given to the hypothesis that ablating rotor regions might be a good strategy in treating persAF.
Objective: we aiming to study the correlation between high dominant frequencies and rotors in persAF patients who underwent catheter ablation targeting high DF. The pre and post-ablation maps of high DF were compared to see the effect of ablation of high DF.
Methods: This study recruited 10 persAF patients, who underwent catheter ablation 3D non-contact mapping using a multi-electrode array. 60 s segments of VEGMs were used and QRST subtraction. DF was defined as the interval between 4 -10 Hz for the 2048 VEGMs. The high DF were identified within +/-0.25 Hz range of DF. Reconstruction of instantaneous phase of VEGM was calculated using the sinusoidal recomposition concept, a rotor was defined as PS, with a duration of at least 100 ms.
Results: The results showed poor spatial correlation between the High DFs with rotors in pre vs post-ablation cases for both the non-terminated (CORR: 0.05± 0.17 vs - 0.03± 0.19) with terminated patients ( CORR= - 0.01 ± 0.03 vs - 0.02 ± 0.04 ). The high DF and rotors seem to have a relationship with the most visited anatomical regions of LA with septum being the most visited. The frequency range of high DF in non-terminated patients is higher than the terminated (8.16 Hz ± 1.10 vs 7.29 Hz ± 0.84). The number of rotors in terminated patients was higher than non-terminated (34 ±11.2 vs 69±14.8). The percentage of rotors ablated in non-terminated vs terminated was(22.8 ± 7.3 vs 22.4 ± 4.8) and not ablated (non-terminated patients vs terminated was: 78.2 ± 7.0 vs 76.7 ± 5.5).The detected rotors of VEGMs lack spatial stability.
Conclusion: The results showed that high DF were poorly correlated with rotors. However, the high DF and rotors do visit the same anatomical regions of LA. Although, the number rotors in the termination group were higher than non-terminated patients, whereas the percentage of rotors ablated were similar in both groups. Therefore, combining high DF and rotor mapping for better identifying targets for AF termination will improve the clinical outcomes.